The Guam Cancer Registry (GCR) will facilitate the identification and recruitment of Guam cancer patients into prevention and control research studies to examine ethnic disparities in cancer incidence and survival. The establishment of a population-based, rapid cancer case ascertainment system is essential to epidemiological, therapeutic, and behavioral research. The GCR will serve as the basis for prioritizing and evaluating cancer education, early detection, and outreach programs developed through the U56. During the funding period, we will enhance the quality, comparability, and the utility of GCR data, and bring the registry into compliance with North American Association of Central Cancer Registry (NAACCR) standards. We have the following objectives during the five years of this award: 1) Train a full-time GCR staff member with the goal of receiving national certification as tumor registrar; 2) Expand the data items collected and coded to be consistent with Hawaii Tumor Registry standards; 3) Implement follow-up on all cancer survivors through passive record linkage and active correspondence; 4) Define and implement an overall program of quality assurance; 5) Pursue the active participation of the Naval Hospital in cancer registration; 6) Expand coverage into non-hospital pathology laboratories located in Hawaii and the US mainland; and 7) Encourage staff participation in national professional associations.